Over 780,000 strokes occur annually in the U.S. with at least 125,000 directly related to intracranial atherosclerosis (ICAD). Despite the important consequences of ICAD, its prevalence remains unclear. Traditional ICAD diagnosis has depended on stenosis measured by angiography;however, in other vascular beds, lumen narrowing is a poor indicator of plaque burden when vessels accommodate plaques by remodeling. The ability to detect and characterize plaque in vivo without relying on lumen assessment has recently been shown in extracranial plaque using high-resolution MRI. We propose to develop high-resolution MRI techniques to characterize the unique features of ICAD. This will be implemented in an NIH-funded population-based study, the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), to investigate ICAD prevalence in the US and factors that lead to its development and stroke. In the K99 training phase of this grant, I will be supervised by an outstanding team of mentors with expertise in neuroradiology, neurology, pathology, MRI physics and epidemiology. Training will be conducted via course work, mentored research, and progress reviews. The major objective of my mentored research is to determine ICAD prevalence, and examine ICAD stenosis and burden in relation to risk factors and vascular markers. In the independent phase (R00), I will apply knowledge gained from the first grant period (K99) to characterize ICAD plaque components and determine associations of these components with ischemic stroke. My overall hypothesis is that high- resolution MRI vessel wall and plaque imaging will improve our ability to stratify stroke risk, thereby enabling new strategies for primary stroke prevention and treatment. The training environment at Johns Hopkins is especially well-suited for this research since it offers access to state-of-the art instrumentation and an infrastructure with a long track-record of supporting clinical research. Relevance: New MRI methodologies for characterizing intracranial atherosclerotic plaque morphology and composition will stratify risk for ischemic events and lesion progression. Information obtained from high resolution MRI of atherosclerosis can be valuable in refining strategies for primary stroke prevention and treatment.

Public Health Relevance

New MRI methodologies for characterizing intracranial atherosclerotic plaque morphology and composition will stratify risk for ischemic events and lesion progression. Information obtained from high resolution MRI of atherosclerosis can be valuable in refining strategies for primary stroke prevention and treatment. )

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Career Transition Award (K99)
Project #
5K99HL106232-02
Application #
8424218
Study Section
Special Emphasis Panel (ZHL1-CSR-P (O2))
Program Officer
Scott, Jane
Project Start
2012-02-09
Project End
2014-01-31
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
2
Fiscal Year
2013
Total Cost
$87,448
Indirect Cost
$6,478
Name
Johns Hopkins University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218